Published: 2014-08-22

Rapid or Normal Gastric Emptying as New Supportive Criteria for Diagnosing Cyclic Vomiting Syndrome in Adults

Chad J. Cooper, Sarmad Said, Jorge Bizet, Haider Alkahateeb, Irene Sarosiek, Richard W. McCallum

(Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA)

Med Sci Monit 2014; 20:1491-1495

DOI: 10.12659/MSM.890547

Background: Cyclic vomiting syndrome (CVS) in adults is a disorder characterized by recurrent and stereotypic episodes of severe nausea, vomiting and abdominal pain separated by symptom-free intervals. Our goal was to investigate gastric emptying (GE) in CVS patients.
Material and Methods: This was a retrospective study of 30 adult patients who met Rome III diagnostic criteria for CVS. Rapid GE was defined using two different predefined criteria as either <50% isotope retention or <65% isotope retention at 1st hour and/or <20% at 2nd hour.
Results: Of the 30 patients (25 had 4-hr GE) diagnosed with CVS, 22 were females and 8 males with a mean age of 39 years. Overall, 20 (80%) of the 25 CVS patients met the predefined criteria of <50% retention for rapid GE in the first hour. Fifteen (60%) met the 2-hour criteria for rapid emptying of <20% retention. Five (16.6%) patients of the 25 had a normal GE with a mean retention at the first hour of 65% (52–78%). Nine (36%) also met another predefined criteria of <35% retention for rapid GE in the first hour. Sixteen (64%) met criteria for normal GE.
Conclusions: (1) In adult CVS patients, GE is either rapid or normal, clearly distinguishing this entity from gastroparesis. (2) Cyclic vomiting syndrome is an important new etiology to explain the finding of rapid GE on a radionuclide test. (3) We suggest that rapid gastric emptying should be added as supportive criteria for diagnosing CVS in adults.

Keywords: Gastric Emptying, Gastroparesis, Nausea, Vomiting

Published: 2014-08-21

Suicidal Behavior in Schizophrenia may be Related to Low Lipid Levels

Babajohn Ainiyet, Janusz K. Rybakowski

Med Sci Monit 2014; 20:1486-1490

DOI: 10.12659/MSM.890884

Published: 2014-08-20

Osteoporosis in the Jawbones: A Correlative Factor of Primary Trigeminal Neuralgia?

Li Liu, Hu Wang, Na Liu, Qianmei Yang, En Luo

Med Sci Monit 2014; 20:1481-1485

DOI: 10.12659/MSM.890935